Catarina Canário

Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression

BACKGROUND This prospective cohort study explored the effects of prenatal and postpartum depression on breastfeeding and the effect of breastfeeding on postpartum depression. METHOD The Edinburgh Postpartum Depression Scale (EPDS) was administered to 145 women at the first, second and third trimester, and at the neonatal period and 3 months postpartum. Self-report exclusive breastfeeding since birth was collected at birth and at 3, 6 and 12 months postpartum. Data analyses were performed using repeated-measures ANOVAs and logistic and multiple linear regressions. RESULTS Depression scores at the third trimester, but not at 3 months postpartum, were the best predictors of exclusive breastfeeding duration (β = -0.30, t = -2.08, p < 0.05). A significant decrease in depression scores was seen from childbirth to 3 months postpartum in women who maintained exclusive breastfeeding for ⩾3 months (F 1,65 = 3.73, p < 0.10, η p 2 = 0.05). CONCLUSIONS These findings suggest that screening for depression symptoms during pregnancy can help to identify women at risk for early cessation of exclusive breastfeeding, and that exclusive breastfeeding may help to reduce symptoms of depression from childbirth to 3 months postpartum.

Breastfeeding and postpartum depression: state of the art review

OBJECTIVE To review the literature on the association between breastfeeding and postpartum depression. SOURCES A review of literature found on MEDLINE/PubMed database. SUMMARY OF FINDINGS The literature consistently shows that breastfeeding provides a wide range of benefits for both the child and the mother. The psychological benefits for the mother are still in need of further research. Some studies point out that pregnancy depression is one of the factors that may contribute to breastfeeding failure. Others studies also suggest an association between breastfeeding and postpartum depression; the direction of this association is still unclear. Breastfeeding can promote hormonal processes that protect mothers against postpartum depression by attenuating cortisol response to stress. It can also reduce the risk of postpartum depression, by helping the regulation of sleep and wake patterns for mother and child, improving mothers self-efficacy and her emotional involvement with the child, reducing the childs temperamental difficulties, and promoting a better interaction between mother and child. CONCLUSIONS Studies demonstrate that breastfeeding can protect mothers from postpartum depression, and are starting to clarify which biological and psychological processes may explain this protection. However, there are still equivocal results in the literature that may be explained by the methodological limitations presented by some studies.

Fathers’ parenting self-efficacy during the transition to parenthood

Abstract Background Little is known about the development of fathers’ parenting self-efficacy during the transition to parenthood. Objectives To analyse (1) fathers’ parenting self-efficacy developmental path and (2) the effects of anxious and depressive symptoms and coparenting support on fathers’ parenting self-efficacy developmental path, from the first trimester of pregnancy to 6 months postpartum. Methods Eighty-six fathers recruited at the first trimester of pregnancy completed self-report measures of anxious and depressive symptoms, coparenting support and parenting self-efficacy at the first and third trimesters of pregnancy, and at 1 and 6 months postpartum. Growth curve models were performed. Results An increase in fathers’ parenting self-efficacy was found from the first trimester of pregnancy to 6 months postpartum. The main effects of anxious symptoms and interaction effects of anxious symptoms and time were found on fathers’ parenting self-efficacy. Fathers with higher anxious symptoms revealed lower levels of parenting self-efficacy at the first trimester of pregnancy and a lower increase of parenting self-efficacy from this time to 6 months postpartum. The main effects of coparenting support were found in fathers’ parenting self-efficacy. At the first trimester of pregnancy, fathers who perceived more coparenting support revealed higher levels of parenting self-efficacy. Conclusion The present study may contribute to the literature by describing fathers’ parenting self-efficacy developmental path and the effects of anxious symptoms and coparenting support on fathers’ parenting self-efficacy developmental path during the transition to parenthood.

Women and men’s psychological adjustment after abortion: a six months prospective pilot study

Background The psychological impact of abortion is a controversial issue. While some studies indicate that women who had elective abortions present lower psychological distress when compared with those who had spontaneous or therapeutic abortions, other studies found abortion to be associated with significant psychological distress. Objectives To assess psychological adjustment (emotional disorder, trauma symptoms and couple relationship) one and six months after abortion, and gender differences regarding psychological adjustment, and to assess the moderation role of couple relationship in the effect of the etiology of abortion on emotional disorder and trauma symptoms. Methods Women (n=50) with different etiologies of abortion agreed to participate, as well as 15 partners (N=65). Assessments took place one and six months after abortion. Measures included the Brief Symptoms Inventory, the Impact of Event Scale-Revised and the Relationship Questionnaire. Results A decrease in emotional disorder for all etiologies of abortion and an increase in perceived quality of couple relationship in therapeutic abortion were observed over time. Couple relationship moderates the effect of the etiology of abortion on trauma symptoms one month after abortion. Conclusion Psychological adjustment after abortion seems not to be exclusively related to its etiology, being influenced by other factors such as couple relationship.

Sleep during the third trimester of pregnancy: the role of depression and anxiety

Depression has been associated with sleep disturbances in pregnancy; however, no previous research has controlled the possible confounding effect of anxiety on this association. This study aims to analyze the effect of depression on sleep during the third trimester of pregnancy controlling for anxiety. The sample was composed by 143 depressed (n = 77) and non-depressed (n = 66) pregnant women who completed measures of depression, anxiety, and sleep. Differences between groups in sleep controlling for anxiety were found. Depressed pregnant women present higher number of nocturnal awakenings and spent more hours trying falling asleep during the night and the entire 24 h period. Present findings point out the effect of depression on sleep in late pregnancy, after controlling for anxiety.

Anxiety and depressive symptoms in women and men from early pregnancy to 30 months postpartum

Abstract Aims: The aims of this study were to analyse the changes in anxiety and depression symptoms from early pregnancy to 30 months postpartum according to gender and parity. Method: 129 couples (N = 258) recruited from an obstetrics unit completed self-report measures of anxiety and depression at each pregnancy trimester, childbirth, 3 and 30 months postpartum. Using multilevel modelling, piecewise dyadic growth curve models were performed, assessing time, gender and parity as predictors of anxiety and depression symptoms. Results: Anxiety and depression symptoms decreased from the first trimester to 3 months postpartum and increased from 3 to 30 months postpartum, returning to the baseline levels in the overall sample. The symptoms were positively correlated within-dyad; in a given time point when a partner reported more symptoms, the other reported more symptoms as well. Changes in anxiety and depression symptoms over time were different according to gender and parity, especially from 3 to 30 months postpartum. Primiparous women revealed low stable symptoms, whereas multiparous women revealed the steepest symptoms increase (in comparison to primiparous men and women and multiparous men). Conclusions: This study corroborates the literature considering that the transition to parenthood can last until the child’s age of 2 or 3 years. Results point out that the risk for anxiety and depression symptoms increasing over the postpartum period is greater for multiparous and lesser for primiparous women. Future studies should explore the factors that contribute to the high risk of symptoms increase over the postpartum period for multiparous women. Screening and intervention should target couples and not only women.

Does Temperament Moderate the Relation between Preschool Parenting and School-Age Self-Regulation? Contrasting Diathesis-Stress and Differential Susceptibility Models

SYNOPSIS Objective. Children vary in how sensitive they are to environmental influences. Child temperament is an individual difference factor that appears to moderate the impact of environment on early child development. This study contrasts the “diathesis-stress/dual risk” and “differential susceptibility” models in examining difficult temperament as a moderator of the relation between preschool parenting and school-aged child persistence. Design. A longitudinal design included 61 typically developing Portuguese children (31 girls) assessed when they were toddlers (Time 1 at 1–3 years), preschoolers (Time 2 at 4–6 years), and school aged (Time 3 at 8–10 years). At Time 1, parents were recruited and interviewed. At Time 2, semi-structured mother–child interactions were observed, and preschool teachers rated children’s temperament. At Time 3, children’s task persistence was rated by their elementary teachers. Results. Difficult temperament moderated the association between mother–child interactions and child persistence, with stronger associations for children with more difficult temperaments. Conclusions. Consistent with the diathesis-stress model, results reveal that high levels of positive parenting reduce the risk of low self-regulation associated with difficult temperament.

Adaptation and Validation of a Measure of Students’ Adaptive and Maladaptive Ways of Coping With Academic Problems

Little research has, to date, explored students’ coping in the academic domain. Yet, children and adolescents frequently refer daily academic difficulties as a common source of stress. The ways children respond to academic demands have the potential to make a difference in their learning and achievement. Therefore, the availability of a measure of academic coping is of critical importance to expand educational research and practice in this area. The current study adapted and validated the Portuguese language version of the Multidimensional Measure of Coping (MMC). Cognitive interviewing, confirmatory factor analysis, and measurement invariance testing using calibration and validation samples provided sound support for the validity of the MMC to measure academic coping among Portuguese elementary and middle school students. Furthermore, the external and discriminant validity of the scale was established based on the relations found between adaptive and maladaptive coping and their differential functionality for academic performance.

The benzodiazepines use and psychological intervention in a Porto health center: Benzodiazepinas e o acompanhamento psicológico dos utentes de um centro de saúde da cidade do Porto

The misuse of benzodiazepines is a well know public health problem. For this reason, it is more and more relevant to monitor misuse and try to implement solutions. We aim to understand the use of benzodiazepines in a health center population in the city of Porto, as well the connections with present, past and future psychological intervention. We have built a questionnaire to assess usage of both benzodiazepines and psychological services. Our sample population included individuals older than 18 years who picked up our questionnaire in health center waiting rooms. A total of 352 participants, 258 females and 92 males, answered the questionnaire. Results points to an excessive use of benzodiazepines, especially in older persons, divorced or widowed, and females. We found a significant association between the current interest in receiving psychological intervention and the use of benzodiazepines. In the same way, the participants who have received psychological intervention use benzodiazepines less in comparison to the participants who are still receiving psychological intervention. In conclusion, there is an abuse of benzodiazepines in this health center, and few access to psychological intervention that may have good results reducing benzodiazepines abuse.